Novel Minimally Invasive Technique of Neovaginoplasty Using an Absorbable Adhesion Barrier

Anagani, Manjula; Agrawal, Prabha; Meka, Krishnakumari; Narayana, Rashmi Thippasandra; Bandameedipally, Radhika

doi:10.1016/j.jmig.2019.02.025

Cited by 14 publications

(12 citation statements)

References 16 publications

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“…23 A large Indian study by Anagani et al over 8 years with 52 women with MRKH showed operative time of 35 min, and neovaginal length of average 8.4 cm, which is comparable with our study. 24 It is not only the length of neovagina that is important but the function also plays a major role in sexual satisfaction and with Interceed the epithelization takes place within 3 months.…”

Section: Discussionmentioning

confidence: 99%

Comparative Study of Creation of Neovagina Using Skin Graft and Interceed in Mayer–Rokitansky–Küster–Hauser Syndrome

Dixit¹,

Bhalerao²,

Mehta³

et al. 2022

Journal of South Asian Federation of Obstetrics and Gynaecology

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Objective: This study compared and evaluated the outcomes of using Interceed and skin graft in vaginoplasty for women with Mayer-Rokitansky-Kuster-Hauser (MRKH) syndrome on the basis of vaginal length (neovagina), procedure safety, patient satisfaction (sexual) after marriage, ease of procedure, procedure time, and morbidity. Materials and Method: Over the course of 18 months, this hospital-based randomized controlled trial was conducted at a tertiary care center. There were 17 women with primary amenorrhea and MRKH syndrome who had undergone vaginoplasty and met the inclusion and exclusion criteria. Nine women received vaginoplasty with Interceed and eight women got vaginoplasty with skin graft, and they were monitored for 6 months postmarriage using a computerized block randomization system. Anatomical and functional outcomes were assessed in these women. The percentage, mean, and standard deviation (SD) were calculated using Epi Info program. For the analysis, the Mann-Whitney and Fischer tests were used. Observations: Women in group A (Interceed) were 22.322 ± 1.59 years old, whereas those in group B (split-thickness skin transplant) were 23.85 ± 1.83 years old. On day 8, the length of the vagina in women who had vaginoplasty with Interceed (Group A) was 8.8330.4153 cm, which was longer than 8.413 ± 0.4190 cm in women who had split-thickness skin transplant (Group B). The vaginal width was determined to be two-finger breadth in both groups. The duration of surgery in women undergoing vaginoplasty with Interceed (Group A) was 32 ± 4.243 minutes as compared to split-thickness skin graft (Group B) where it was 61.38 ± 8.634 minutes. This difference is statistically significant. The functional outcome in relation to sexual satisfaction (lubrication, orgasm, satisfaction, and pain) in women undergoing vaginoplasty with Interceed was 77.8% as compared to 37.5% with Split-thickness skin graft. Conclusion: By using Interceed for vaginoplasty, gynecologist is independent and no separate procedure is required for graft. It is safe, easy, effective, less time-consuming and patient satisfaction with anatomical and functional outcome is good due to squamous epithelization. Hence, is a potential alternative for vaginal agenesis.

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Section: Discussionmentioning

confidence: 99%

Comparative Study of Creation of Neovagina Using Skin Graft and Interceed in Mayer–Rokitansky–Küster–Hauser Syndrome

Dixit¹,

Bhalerao²,

Mehta³

et al. 2022

Journal of South Asian Federation of Obstetrics and Gynaecology

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“…To solve this problem, some authors have proposed the use of molds with different dimensions or personalized molds [18,19]. Anagani et al [20] recently published data on the modification of the McIndoe technique in 52 patients in India, in which acceptable short-term physiological and psychological results and adequate epithelialization of the neovagina were achieved between 4 and 6 months. An invariable mold was used in these cases.…”

Section: Discussionmentioning

confidence: 99%

Classical McIndoe Technique Versus the McIndoe Technique with a Neovaginal PACIENA Prosthesis® and No Skin Graft

Navarro

Acién

2020

JCM

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An observational, retrospective study was completed to compare the results of the PACIENA clinical trial (using the modified McIndoe technique) with a historical control group of nine patients who were operated on at San Juan University Hospital (1992–2015) using the classic technique. The PACIENA clinical trial included seven patients with vaginal agenesis who were operated on at two reference sites (May 2017–May 2018) using a neovaginal polylactic acid (PLA) prosthesis (PACIENA® prosthesis) and avoiding the use of a skin graft. The results illustrate a reduction in the length of surgery, 86.43 ± 4.75 min in the group with no skin graft compared to 155.56 ± 28.44 in the control group (p < 0.05); and reduction in the length of hospitalization time. Differences were also registered in the length of the neovagina, the average being 8.93 ± 1.42 cm for cases and 6.56 ± 1.13 cm for controls, with no differences in neovaginal epithelialization times or in the satisfaction of sexual relations occurring between groups. The modification of the classical McIndoe technique using the neovaginal PACIENA® prosthesis appears to be successful, obtaining good clinical results with shorter surgery and hospitalization times.

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“…Alternatively, amnion, peritoneum, buccal mucosa, absorbable adhesion barriers, or even tissue-engineered biomaterial mesh can be used as graft material. [28][29][30] Vaginal pull-through is also described for vaginal atresia in the pediatric population. 23,27…”

Section: Vaginal Atresia and Aplasia (Or Agenesis)mentioning

confidence: 99%

Surgical disorders in pediatric and adolescent gynecology: Vaginal and uterine anomalies

Mentessidou

Mirilas

2022

Intl J Gynecology & Obste

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Obstructive vaginal and uterine anomalies including imperforate hymen, transverse vaginal septum, and vaginal and/or cervical atresia or aplasia, might rarely present in infancy or childhood with hydrocolpos and/or hydrometra but they usually go unrecognized until presentation with amenorrhea and hematocolpos and/or hematometra in puberty. They should always be included in the differential diagnosis of a suprapubic and/or introital mass; in the latter case, vaginal vascular malformations and vaginal tumors should also be considered. Uterovaginal aplasia typically manifests with amenorrhea in puberty and needs to be differentiated from complete androgen insensitivity syndrome and gonadal dysgenesis of genetic males. Uterine fusion anomalies usually present with fertility and/or obstetrical complications in adulthood. However, a unicornuate uterus with a blind rudimentary contralateral horn containing functioning endometrium, and didelphys or septate uterus with a deviating obstructive septum might present in childhood or puberty with sequelae related with secretions or menstrual retention. This review provides a collective account of the most clinically important information about vaginal and uterine anomalies in childhood and adolescence for clinicians involved in the care of young females with the aim to provide guidance in appropriate evaluation and management.

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Novel Minimally Invasive Technique of Neovaginoplasty Using an Absorbable Adhesion Barrier

Cited by 14 publications

References 16 publications

Comparative Study of Creation of Neovagina Using Skin Graft and Interceed in Mayer–Rokitansky–Küster–Hauser Syndrome

Comparative Study of Creation of Neovagina Using Skin Graft and Interceed in Mayer–Rokitansky–Küster–Hauser Syndrome

Classical McIndoe Technique Versus the McIndoe Technique with a Neovaginal PACIENA Prosthesis® and No Skin Graft

Surgical disorders in pediatric and adolescent gynecology: Vaginal and uterine anomalies

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